The government will begin talks with the Greens next week to introduce a Medicare-like system that will pay ­private dentists to provide care for those on lower incomes.

This would replace an existing, non-means tested system that pays for dental work for patients with chronic disease who are referred by doctors. That system is open to abuse, with expensive bridge and other cosmetic dental work supplied free for the well-to-do.

The new approach would be targeted at the 30 per cent of Australians who don’t have access to dental services. It’s backed by the bulk of 13,750 registered dentists who work in the ­private sector.

After ploughing $500 million into the public dental system and related projects in the budget last week, the government’s attention has shifted to the hundreds of millions of dollars it pays the private sector.

“We have agreed to begin negotiations with the Greens about how these foundations can be built upon to deliver better dental care for the 30 per cent of Australians who can’t afford it and can’t access it at the moment," Health Minister
Tanya Plibersek
said.

“When we have come to an agreement on the shape of what comes after this, we will close the Chronic Disease Dental Scheme, which is poorly designed and poorly targeted . . . you can be a millionaire and get $4250 of free dental treatment: not great," Ms Plibersek said.

The cost of the Chronic Disease Dental Scheme went from about $300 million when the Howard government introduced it to $726 million last year, and could nudge $1 billion this year.

The government has tried to shut the scheme twice but the Greens have refused to let it go until a replacement is in place. The government has already factored in savings from its closure in the forward estimates.

“The first step recommended by the National Advisory Council on Dental Health was a waiting list blitz," he said. “That was implemented in full last week.

“The next step is to involve the private workforce because that’s where 85 per cent of the capacity is."

The Greens prefer an entitlement- based model that would establish how much the government would pay for what dental service.

Mr Di Natale expects some heated debate around the numbers of people who would be covered, both to begin with and in later years.

“If you look at the chronic disease scheme now, take out the 20 per cent who are non-concession holders and then put restrictions on the scope per service, the cost of that scheme is almost halved," he said.

Earlier this year, Opposition Leader
Tony Abbott
described a ­universal dental care system as an “aspirational target" once the federal budget returned to a strong surplus.

The Australian Dental Association estimates such a system would cost an unaffordable $10 billion a year.

It prefers a means-tested solution for the 30 per cent to 35 per cent of the population who don’t have access to treatment. This would cost between $3 billion and $3.5 billion a year.

“We don’t want to end up with poor dentistry for the disadvantaged and good dentistry for the more fortunate," ADA president Shane Fryer said.

The ADA also backs an entitlement-based model, noting that the industry already has a schedule of dental ­services.

The increase in demand from the scheme would also help soak up extra capacity in the dental workforce.

In the 10 years to 2006, 250 new dentists graduated each year. Since 2006 that has increased to 300. Next year it will climb to 450, and a further 200 overseas dentists migrate each year.